suprapubic fat pad excision with simultaneous placement of ...€¦ · suprapubic fat pad excision...

Suprapubic Fat Pad Excision with

Simultaneous Placement of Inflatable

Penile Prosthesis

Adam S. Baumgarten1, Jonathan A. Beilan1, Bhavik B. Shah1, Jared J. Wallen, Michael Bickell1,Justin Parker, Gerard D. Henry2,

Rafael E. Carrion1

1University of South Florida; Tampa, FL2Regional Urology; Shreveport, LA

Disclosure

Nothing to disclose

Objective

Many men suffering from erectile dysfunction are

overweight and have generous suprapubic fat

pads

Suprapubic fat pads can contribute to decreased

visible exophytic phallic length

We describe a novel surgical concept of

suprapubic fat pad excision with concomitant

placement of inflatable penile prosthesis

Ideal Patient

• Overweight with

large suprapubic fat

pad

• Decreased

exophytic phallic

length

• “Double belly” sign

“Double Belly” Sign

Technique

Incision is made 2 cm inferior and medial to the

ASIS and carried across the infrapubic region in

a curvilinear fashion

Passes one finger breath above the base of the

penis

Dissection is carried down to anterior abdominal

fascia, and fat pad is excised

Suspensory ligament can be released

Fat Pad Excision

Technique

IPP placed via same incision similar to infrapubic

approach

2 JP drains are placed prior to closure

Results

8 patients underwent suprapubic fat pad excision with

simultaneous placement of IPP

Mean BMI was 36.1

At last follow up, all patients have excellent cosmetic and

functional outcomes

No known complications have occurred secondary to the fat

pad excision in our cohort

Before and After

Before and After

Conclusions

Suprapubic fat pad excision is a safe and

reproducible technique that can be performed

simultaneously with placement of IPP in appropriately

selected patients

Can lead to higher patient satisfaction, enhanced

sexual performance, and improved quality of life